The 4 Stages of Diabetic Retinopathy: What You Can Expect

You know that diabetes is a life-threatening disease that affects the sugar levels in your blood. You probably also know common symptoms of diabetes like frequently needing to urinate, constantly feeling thirsty, and very slow wound healing, among others.

What you might not know is that diabetes can also affect your eyes. The vision condition associated with diabetes is called diabetic retinopathy. The condition is treatable especially when caught early.

What is diabetic retinopathy?

Diabetic retinopathy occurs when high blood sugar levels damage the vessels in the part of your eye called the retina. It occurs in most people with diabetes, but can sometimes be so mild it is not even noticed. In other cases, the condition can lead to vision loss. 

Diabetic Retinopathy Stages

Diabetic retinopathy generally takes place in four stages: mild, moderate and severe nonproliferative retinopathy, and proliferative diabetic retinopathy, also known as PDR.

Mild nonproliferative diabetic retinopathy is also called background retinopathy. In this stage, there are tiny bulges, or microaneurysms, in the blood vessels in the retinas. This stage rarely requires treatment, and your eye doctor can give you advice on how to prevent it from getting worse. 

The second stage, moderate nonproliferative retinopathy, blood vessels in the retinas swell and can no longer carry blood as well as they used to. As it advances to the third stage and becomes severe, blood vessels become blocked and blood cannot reach the retinas. It can lead to blurry vision or dark spots called “floaters” on the vision.

In the fourth and final stage, proliferative diabetic retinopathy, new blood vessels grow in the eyes to replace the blocked vessels. These new vessels often bleed and cause scar tissue which will ultimately lead to loss of vision. 

Can Diabetic Retinopathy Be Reversed?

Unfortunately, no, the damage caused by diabetic retinopathy is permanent. Generally, though, it can be caught early enough during regular eye exams that it can be treated and advanced retinopathy can be avoided. The signs of diabetic retinopathy on a fundoscopy – the part of your eye exam during which your eyes are dilated – includes microaneurysms, white fluffy patches on the retinas, and bleeding in the retinas.  

Living with Diabetic Retinopathy

The idea of losing our vision or something going wrong with our eyes can be scary. Fortunately, there are several treatments that can either slow or stop the progression of this disease. This is also a condition in which the best defense is a good offense. Managing your blood sugar levels with diet, medication and exercise is the best way to slow or prevent diabetic retinopathy.

Some treatments that might be used for diabetic retinopathy include:

• Laser surgery to reduce abnormal blood vessels
• A steroid shot in the eye to reduce inflammation and prevent new blood vessels from forming. 
• An eye surgery called vitrectomy to remove scar tissue, blood, fluid, and some of the vitreous gel from the eye so the retina can properly focus on light rays. 

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If you or your loved one has had diabetes for a long period of time, they are likely to develop some level of diabetic retinopathy. The key to reducing their risk of the most serious outcomes is being diligent with eye exams and early treatment. By doing these two things, the likelihood of serious vision loss can be small.

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